title: [A case of interstitial lung diseases in patient treated with oxaliplatin, 5-fluorouracil and leucovorin (FOLFOX)].
abstract: FOLFOX/bevacizumab has been shown to be a promising chemotherapeutic regimen for advanced or metastatic colorectral cancer. We reported a case of intestinal lung diseases occurring in association with the use of this combination chemotherapy. The patient presented here is a 71-year-old man with lung metastasis of rectal cancer who was treated with FOLFOX4/ bevacizumab. He complained of high fever in the eleventh course of a FOLFOX4/bevacizumab regimen. Chemotherapy was stopped. But fourteen days after, he suffered from dyspnea and soon went into respiratory failure of WHO grade 3 with severe hypoxemia. He was diagnosed with interstitial pneumonitis. Corticosteroid therapy consisting of metylprednisolone(1 g/day) for tree days was significantly effective in treatment of respiratory failure. Drug-induced interstitial pneumonitis was suspected from chest X-ray and CT. We performed DLST of oxaliplatin, l-levofolinate, 5-FU and bevacizumab for him. He was positive for oxaliplatin and l-levofolinate and 5-FU, and negative for bevacizumab. Interstitial pneumonitis induced by FOLFOX/bevacizumab chemotherapy is rare, but six patients had developed, one of whom died in post-marketing surveillance. The possibility of interstitial pneumonitis should always be considered when a patient presents with a respiratory disorder while undergoing systemic chemotherapy.
authors.affiliation: Dept. of Pharmacy, Izumi Municipal Hospital.
authors.forename: Masafumi
authors.initials: M
authors.lastname: Nakagawa
authors.forename: Aiko
authors.initials: A
authors.lastname: Hamada
authors.forename: Yukari
authors.initials: Y
authors.lastname: Yoshihara
authors.forename: Toshihiko
authors.initials: T
authors.lastname: Ishizaka
authors.forename: Makoto
authors.initials: M
authors.lastname: Fukushima
authors.forename: Naotsugu
authors.initials: N
authors.lastname: Takahashi
authors.forename: Ryugo
authors.initials: R
authors.lastname: Sawada
authors.forename: Junji
authors.initials: J
authors.lastname: Mukai
mesh_terms: D000368:Aged; D000971:Antineoplastic Combined Chemotherapy Protocols / Q000009:adverse effects* / Q000627:therapeutic use; D005472:Fluorouracil / Q000009:adverse effects / Q000627:therapeutic use; D006801:Humans; D002955:Leucovorin / Q000009:adverse effects / Q000627:therapeutic use; D017563:Lung Diseases, Interstitial / Q000139:chemically induced*; D008175:Lung Neoplasms / Q000188:drug therapy* / Q000556:secondary; D008297:Male; D009944:Organoplatinum Compounds / Q000009:adverse effects / Q000627:therapeutic use; D012004:Rectal Neoplasms / Q000188:drug therapy* / Q000473:pathology; D014057:Tomography, X-Ray Computed
chemical_list: D009944:Organoplatinum Compounds; D002955:Leucovorin; D005472:Fluorouracil